By Patience Ukama
In Zimbabwe’s Zambezi Basin, summer temperatures regularly soar above 40°C. For many communities, extreme heat is no longer an occasional weather event—it is becoming a defining feature of daily life. Yet among those bearing the greatest burden are pregnant and postpartum women, whose health and wellbeing are increasingly threatened by rising temperatures linked to climate change.
Across the world, scientists are uncovering growing evidence that extreme heat poses serious risks during pregnancy, including dehydration, heat stress, preterm birth, and other adverse maternal and newborn health outcomes. While the challenge is global, the solutions must be rooted in local realities.
That belief sits at the heart of the Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe’s project in the Zambezi Basin, supported by Wellcome. The initiative, led by Dr Fortunate Machingura, is testing practical, affordable and community-led approaches to protect pregnant women and newborns from the impacts of extreme heat.
A new Wellcome-produced film shines a spotlight on this pioneering work, documenting how communities are responding to one of the most urgent and under-recognised public health challenges of our time.
Communities are not waiting for solutions—they are creating them
Climate adaptation efforts are often designed far from the communities they intend to serve. As a result, interventions can overlook critical cultural, social and environmental realities.
The CeSHHAR project takes a different approach.
Working alongside local leaders, health workers, women and families, the programme has co-developed solutions that are both evidence-based and culturally relevant. Community ownership is not an afterthought—it is the starting point.
One of the most impactful innovations has been the introduction of Heat Champions—trusted community members who share information on heat-related health risks and practical ways to stay safe during pregnancy and the postpartum period. Their work is strengthened through the endorsement of traditional leaders, including Chiefs, whose influence helps ensure critical health messages reach households across the region.
The project provides personal cooling kits to pregnant and postpartum women, equipping them with practical tools to manage exposure to extreme temperatures. These seemingly simple interventions can make a significant difference in comfort, hydration and overall wellbeing during the hottest months of the year.
Resilience is a collective effort
The film highlights an important reality: protecting maternal health in a changing climate is not solely the responsibility of women.
In many communities participating in the project, men’s groups have become active partners in adaptation efforts. Some travel several kilometres to collect and transport water for vulnerable households, helping reduce the physical burden on pregnant women while ensuring access to a critical resource during periods of intense heat.
These actions demonstrate that climate resilience is strongest when communities work collectively. They challenge traditional assumptions about caregiving while creating practical support systems that benefit entire families.
Adaptation is not only about infrastructure and technology. It is equally about strengthening social cohesion, solidarity and shared responsibility.
Simple innovations with transformative potential
Among the project’s most promising interventions is a cool-roof initiative, where homes are painted with white reflective paint designed to reduce indoor temperatures.
Early results are encouraging. Residents report noticeably cooler living environments, creating safer and more comfortable spaces for pregnant women and newborns during heatwaves. Importantly, the intervention is low-cost and relatively easy to implement, offering potential for scale across communities facing similar conditions.
The lesson is powerful: climate adaptation does not always require expensive or complex solutions. Sometimes the most effective interventions are practical innovations developed with communities rather than for them.
A model for global climate and health action
As climate change continues to intensify, the intersection between environmental conditions and human health is becoming impossible to ignore. Yet maternal health remains insufficiently represented in climate adaptation policies and investments.
The work underway in Zimbabwe’s Zambezi Basin offers a compelling model for addressing that gap. It demonstrates that effective adaptation can be:
- Community-led, ensuring local ownership and sustainability.
- Evidence-based, grounded in rigorous research and measurable outcomes.
- Scalable, with interventions that can be adapted for other regions facing similar risks.
- Inclusive, engaging women, men, health workers and traditional leaders alike.
This work forms part of a growing international research network supported by Wellcome, bringing together researchers and communities across different countries to better understand the health impacts of extreme heat and identify solutions that can protect those most at risk.
Looking ahead
The challenges posed by climate change will continue to test health systems and communities around the world. But the experience of the Zambezi Basin offers an important reminder: resilience does not begin in laboratories, ministries or conference halls. It begins in communities.
When local knowledge is combined with scientific evidence, innovative and sustainable solutions emerge. By empowering communities to lead adaptation efforts, we can protect maternal and newborn health while building resilience for generations to come.
As the Wellcome film shows, the story unfolding in Zimbabwe is not simply about surviving extreme heat. It is about reimagining how communities, researchers and policymakers can work together to create healthier, more climate-resilient futures.
